JVQ-R2, Abbreviated Interview Version, Caregiver Lifetime Form

Now we are going to ask you about some things that might have happened in your child’s life.

Module A: CONVENTIONAL CRIME

Notes to interviewer: a) Do not read Module labels (“Conventional Crime” etc). These are for your info only.

b) If it’s apparent there was more than one incident, say, “Answer the next questions about the last time this happened.”

c) Try to complete follow-ups from open-ended response to questions. Read response categories only if caregiver needs help.

d) For multiple perpetrators, collect information for up to 5 perpetrators.

C1)At any time in your child’s life, did anyone use force to take something away from your child that your child was carrying or wearing?

1YESGo to C1a

2NOGo to C2

C1a) Did this happen in the last year?

1Yes

2No

C1b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition] “Hurt means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.”

1Yes

2No

C1c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relative who lives in your child’s home (uncle, grandparent, etc.)

5A relative who does not live with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someone else your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C1d) Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C2)At any time in your child’s life, did anyone steal something from your child and never give it back? Things like a backpack, money, watch, clothing, bike, stereo, or anything else?

1YESGo to C1a

2NOGo to C2

C2a) Did this happen in the last year?

1Yes

2No

C2b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition] “Hurt means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.”

1Yes

2No

C2c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relative who lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someone else your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C2d) Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C3)At any time in your child’s life, did anyone break or ruin any of your child’s things on purpose?

1YESGo to C3a

2NOGo to C4

C3a) Did this happen in the last year?

1Yes

2No

C3b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

C3c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relative who lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someone else your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C3d) Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C4)Sometimes people are attacked with sticks, rocks, guns, knives, or other things that would hurt. At any time in your child’s life, did anyone hit or attack your child on purpose with an object or weapon? Somewhere like: at home, at school, at a store, in a car, on the street, or anywhere else?

1YESGo to C4a

2NOGo to C5

C4a) Did this happen in the last year?

1Yes

2No

C4b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day, you had a bruise, you had a cut that bled, or anything more serious like a broken bone.

1Yes

2No

C4c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relativewho lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someoneelse your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C4d) Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C4e) Did the person who did this use any of these?

1Gun

2Knife

3Stick, rock, bottle, pipe, or tool such as a hammer or wrench

4Other (Specify ______)

5No weapon used

C5)At any time in your child’s life, did anyone hit or attack your childwithout using an object or weapon?

1YESGo to C5a

2NOGo to C6

C5a) Did this happen in the last year?

1Yes

2No

C5b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

C5c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relative who lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someone else your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C5d)Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C6)At any time in your child’s life, did someone start to attack your child, but for some reason, it didn’t happen? For example, someone helped your child or your child got away?

1YESGo to C6a

2NOGo to C7

C6a)Did this happen in the last year?

1Yes

2No

C6b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

C6c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relativewho lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someoneelse your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C6d) Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C7) At any time in your child’s life, did someone threaten to hurt your child when your child thought they might really do it?

1YESGo to C7a

2NOGo to C8

C7a)Did this happen in the last year?

1Yes

2No

C7b) Were you physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

C7c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relativewho lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someoneelse your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C7d) Was this person a man, woman, boy, or girl?

1Man

2Woman

3Boy

4Girl

C8)At any time in your child’s life, did anyone try to kidnap your child?

1YESGo to C8a

2NOGo to C9

C8a) Did this happen in the last year?

1Yes

2No

C8b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain the next day, you had a bruise, a cut that bled, or anything more serious like a broken bone.

1Yes

2No

C8c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relativewho lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someoneelse your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C8d) Was this person a man, woman, boy or girl?

1Man

2Woman

3Boy

4Girl

C8e) Were you actually kidnapped or did you get away before it happened?

1Kidnapped

2Got away (Note to interviewer: This includes with any help)

C9) At any time in your child’s life, has your child been hit or attacked because of your child’s skin color, religion, or where your child’s family comes from? Because of a physical problem your child has? Or because someone said your child was gay?

1YESGo to C9a

2NOGo to Module B, M1

C9a)Did this happen in the last year?

1Yes

2No

C9b) Were you physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain the next day, you had a bruise, a cut that bled, or anything more serious like a broken bone.

1Yes

2No

C9c) Who did this?

1Brother, sister, or other child who lives with your child (cousin, foster sibling, etc.)

2Father (including step-father, foster father, or live-in boyfriend)

3Mother (including step-mother, foster mother, or live-in girlfriend)

4A relativewho lives in your child’s home (uncle, grandparent, etc.)

5A relative who does notlive with your child

6Your child’s boyfriend, girlfriend, date, or ex-boyfriend or ex-girlfriend

7Someoneelse your child knows such as a friend, neighbor, teacher, or someone from school

8Stranger (a stranger is someone your child doesn’t know)

9Other ______(write in who it was)

C9d) Was this person a man, woman, boy or girl?

1Man

2Woman

3Boy

4Girl

C9e) What was the reason? Was it because of:

1Your child’s skin color

2Your child’s religion

3Where your family comes from

4Because of some physical problem your child has

5Because someone said your child wasgay

Module B: CHILD MALTREATMENT

Next, we are going to ask about grown-ups who take care of your child. This means parents, babysitters, adults who live with your child, or others who watch your child. Before we begin, I want to remind you that your answers will be kept totally private. If there is a particular question that you don't want to answer, that's O.K. But it is important that you be as honest as you can, so that the researchers can get a better idea of the kinds of things that kids your child’s age sometimes face.

M1)Not including spanking on your child’s bottom, at any time in your child’s life, did a grown-up in your child’s life hit, beat, kick, or physically hurt your child in any way?

1YESGo to M1a

2NOGo to M2

M1a)Did this happen in the last year?

1Yes

2No

M1b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

M1c) Who did this?

1Father

2Step-father

3Foster father

4Mother

5Step-mother

6Foster mother

7Parent’s boyfriend or girlfriend who lives with your child

8Parent’s boyfriend or girlfriend who does notlive with your child

9Uncle, aunt, grandparent, or other adult relative who lives in your child’s home

10Grown-up relative, such as uncle, aunt, grandparent, who does notlive with your child

11Grown-up you know but do not live with, such as teacher, coach, neighbor, or babysitter

12Other ______(write in who it was, recode if none in caregiving role)

M1d) Was this person a man, or a woman?

1Man

2Woman

3Boy

4Girl

M1e) Did the person who did this use any of these?

1Gun

2Knife

3Stick, rock, bottle, pipe, or tool such as a hammer or wrench

4Other (Specify ______)

5No weapon used

M2)At any time in your child’s life, did your child get scared or feel really bad because grown-ups in your child’s life called your child names, said mean things to your child, or said they didn’t want your child?

1YESGo to M2a

2NOGo to M3

M2a)Did this happen in the last year?

1Yes

2No

M2b) Who did this?

1Father

2Step-father

3Foster father

4Mother

5Step-mother

6Foster mother

7Parent’s boyfriend or girlfriend who lives with your child

8Parent’s boyfriend or girlfriend who does notlive with your child

9Uncle, aunt, grandparent, or other adult relative who lives in your child’s home

10Grown-up relative, such as uncle, aunt, grandparent, who does notlive with your child

11Grown-up you know but do not live with, such as teacher, coach, neighbor, or babysitter

12Other ______(write in who it was, recode if none in caregiving role)

M2c) Was this person a man, or a woman?

1Man

2Woman

3Boy

4Girl

M3)When someone is neglected, it means that the grown-ups in their life didn’t take care of them the way they should. They might not get them enough food, take them to the doctor when they are sick, or make sure they have a safe place to stay. At any time in your child’s life, did your child get neglected?

1YESGo to M3a

2NOGo to M4

M3a)Did this happen in the last year?

1Yes

2No

M3b) Who did this?

1Father

2Step-father

3Foster father

4Mother

5Step-mother

6Foster mother

7Parent’s boyfriend or girlfriend who lives with your child

8Parent’s boyfriend or girlfriend who does notlive with your child

9Uncle, aunt, grandparent, or other adult relative who lives in your child’s home

10Grown-up relative, such as uncle, aunt, grandparent, who does notlive with your child

11Grown-up you know but do not live with, such as teacher, coach, neighbor, or babysitter

12Other ______(write in who it was, recode if none in caregiving role)

M3c) Was this person a man, or a woman?

1Man

2Woman

3Boy

4Girl

M3d) Did your child get sick when this happened?

1 Yes

2 No

M4)Sometimes a family fights over where a child should live. At any time in your child’s life, did a parent take, keep, or hide your child to stop your child from being with another parent?

1YESGo to M4a

2NOGo to Module C, P1

M4a) Did this happen in the last year?

1Yes

2No

M4b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

M4c) Who did this?

1Father

2Step-father

3Foster father

4Mother

5Step-mother

6Foster mother

7Parent’s boyfriend or girlfriend who lives with your child

8Parent’s boyfriend or girlfriend who does notlive with your child

9Uncle, aunt, grandparent, or other adult relative who lives in your child’s home

10Grown-up relative, such as uncle, aunt, grandparent, who does notlive with your child

11Grown-up you know but do not live with, such as teacher, coach, neighbor, or babysitter

12Other ______(write in who it was, recode if none in caregiving role)

M4d) Was this person a man, or a woman?

1Man

2Woman

3Boy

4Girl

M4e) Did this person take, keep or hide your childto try to keep your child from ever living with this other parent?

1Yes

2No

Module C: PEER AND SIBLING VICTIMIZATIONS

Notes to interviewer:

a) If it’s apparent there was more than one incident, say, “Answer the next questions about the last time this happened.”]

b) Try to complete follow-ups from open-ended response to questions. Read response categories only if caregiver needs help.

P1)Sometimes groups of kids or gangs attack people. At any time in your child’s life, did a group of kids or a gang hit, jump, or attack your child?

1YESGo to P1a

2NOGo to P2

P1a)Did this happen in the last year?

1Yes

2No

P1b) Was your child physically hurt when this happened? [If this is first time injury question is asked, read definition:] “Hurt” means you could still feel pain in your body the next day. You are also hurt when you have a bruise, a cut that bleeds, or a broken bone.

1Yes

2No

P1c) Did the people who did this use any of these?

1Gun

2Knife

3Stick, rock, bottle, pipe, or tool such as a hammer or wrench

4Other (Specify ______)

5No weapon used

P2)(If Yes to P1, say: “Other than what you just told me about…..”) At any time in your child’s life, did any kid, even a brother or sister, hit your child? Somewhere like: at home, at school, out playing, in a store, or anywhere else?